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131. 发明授权

US06366811B1 Extraction of hemodynamic pulse pressure from fluid and myocardial accelerations 有权
标题翻译：从流体和心肌加速度提取血流动力学脉搏压
公开(公告)号：US06366811B1
公开(公告)日：2002-04-02
申请号：US09475860
申请日：1999-12-30
申请人： Gerrard M. Carlson
发明人： Gerrard M. Carlson
IPC分类号： A61N1365
CPC分类号： A61N1/36542 , A61N1/3627 , A61N1/3682
摘要： A cardiac stimulating apparatus and method is described that non-intrusively determines an amount indicative of hemodynamic pulse pressure from an accelerometer signal. The amount indicative of pulse pressure is determined over several cardiac cycles and is used to optimize cardiac performance by evaluating the amount indicative of pulse pressure over varying timing intervals. The timing intervals are measured between at least one of intrinsic and paced stimulations of pre-selected chambers of the heart and a maximum pulse pressure indicates the optimum timing interval under manipulation. The cardiac stimulating apparatus and method may be used in any of several pacing modes including A-V pacing, V-V pacing, or A-A pacing.
摘要翻译：描述了一种心脏刺激装置和方法，其非侵入式地确定来自加速度计信号的指示血流动力学脉搏压力的量。指示脉压的量在几个心动周期上确定，并用于通过评估在变化的时间间隔上指示脉搏压力的量来优化心脏性能。定时间隔是在心脏预先选择的腔室的固有和起搏刺激中的至少一个之间进行测量的，最大脉搏压力指示在操纵下的最佳定时间隔。心脏刺激装置和方法可以以包括A-V起搏，V-V起搏或A-A起搏的多种起搏方式中的任何一种使用。

132. 发明授权

US06301499B1 Heart rate variability as an indicator of exercise capacity 有权
标题翻译：心率变异性作为运动能力的指标
公开(公告)号：US06301499B1
公开(公告)日：2001-10-09
申请号：US09419659
申请日：1999-10-18
申请人： Gerrard M. Carlson , Veerichetty A. Kadhiresan , Julio C. Spinelli
发明人： Gerrard M. Carlson , Veerichetty A. Kadhiresan , Julio C. Spinelli
IPC分类号： A61B50456
CPC分类号： A61N1/365 , A61B5/0245 , A61B5/222 , A61N1/3627 , A61N1/36514 , A61N1/36592
摘要： Based upon patient studies indices a high degree of correlation was found between HRV and VO2max, i.e., the patient's exercise capacity. Based on this finding, a pacing therapy optimization protocol for treating patients with CHF has been devised. The protocol involves first pacing the patient's heart with a pacemaker programmed to operate in a first mode for a predetermined time period and then collecting electrogram data from which a HRV index is derived. The mode is then changed and the steps repeated until all possible modes have been utilized. At that time, a determination is made as to which of the modes is associated with the largest HRV index and the pacemaker is then programmed to function in that mode. Alternatively, the method of the present invention can be applied to changes in drug therapy instead of or in combination with pacing therapy. By the plotting the HRV index computed in the manner described, the efficacy of a change in therapy on patient exercise capacity can be assessed.
摘要翻译：根据患者研究指标，发现HRV和VO2max之间存在高度相关性，即患者的运动能力。基于这一发现，已经设计了用于治疗CHF患者的起搏治疗优化方案。该方案涉及首先用编程为在第一模式中操作预定时间段的起搏器起搏病人的心脏，然后收集从其导出HRV指数的电描记图数据。然后改变模式，重复步骤直到所有可能的模式被使用。此时，确定哪个模式与最大HRV指数相关联，并且起搏器然后被编程为在该模式下起作用。或者，本发明的方法可以应用于药物治疗的变化，而不是起搏治疗或与起搏治疗组合。通过绘制以所述方式计算的HRV指数，可以评估治疗改变对患者运动能力的功效。

133. 发明授权

US5885221A Discrimination of atrial and ventricular signals from a single cardiac lead 失效
标题翻译：从单一心脏导联鉴别心房和心室信号
公开(公告)号：US5885221A
公开(公告)日：1999-03-23
申请号：US996355
申请日：1997-12-22
申请人： William Hsu , Jay A. Warren , Gerrard M. Carlson
发明人： William Hsu , Jay A. Warren , Gerrard M. Carlson
IPC分类号： A61N1/362 , A61B5/0464
CPC分类号： A61N1/3622
摘要： A method and system for discriminating atrial and ventricular signal components from a single heart lead, and for using this information for identifying an arrhythmia condition as being atrial or ventricular in origin. The invention is effective in identifying P waves occurring in complex signal which includes relatively stronger R waves or other ventricular artifacts which mask the P waves. The contribution of the R wave signal to the complex signal is obtained by filtering, time windowing and transfer function estimation, then the R wave estimate is subtracted from the combined signal to leave the P wave. The ratio of P waves to R waves, P-P and R-R intervals, and their ratios to one another and to fixed values can be estimated, and used in a comparison to discriminate between atrial and ventricular arrhythmia, to thereby enable appropriate treatment.
摘要翻译：用于区分来自单个心脏引线的心房和心室信号分量的方法和系统，以及用于将该信息用于将心律失常状态识别为心房或心室起源的方法和系统。本发明有效地识别出复杂信号中出现的P波，其中包含相对较强的R波或掩蔽P波的其他心室伪像。通过滤波，时间窗口和传递函数估计得到R波信号对复信号的贡献，然后将R波估计从组合信号中减去离开P波。可以估计P波与R波，P-P和R-R间隔的比率以及它们彼此之间的比值和固定值，并用于比较以区分心房和心室心律不齐，从而使得能够进行适当的治疗。

134. 发明授权

US5674256A Cardiac pre-ejection period detection 失效
标题翻译：心脏预喷射期检测
公开(公告)号：US5674256A
公开(公告)日：1997-10-07
申请号：US574674
申请日：1995-12-19
申请人： Gerrard M. Carlson
发明人： Gerrard M. Carlson
IPC分类号： A61N1/365
CPC分类号： A61N1/365 , A61N1/36542
摘要： A method of and apparatus for controlling a rate adaptive pacer is disclosed which operates based on the pre-ejection period (PEP), the method including the step of detecting the pre-ejection period utilizing only the pacer ECG signal and an accelerometer transducer signal.
摘要翻译：公开了一种用于控制速率自适应起搏器的方法和装置，其基于预喷射周期（PEP）进行操作，该方法包括仅利用起搏器ECG信号和加速度计换能器信号检测预喷射周期的步骤。

135. 发明授权

US5603331A Data logging system for implantable cardiac device 失效
标题翻译：可植入心脏装置的数据记录系统
公开(公告)号：US5603331A
公开(公告)日：1997-02-18
申请号：US600133
申请日：1996-02-12
申请人： Jan P. Heemels , Gerrard M. Carlson , Julio C. Spinelli
发明人： Jan P. Heemels , Gerrard M. Carlson , Julio C. Spinelli
IPC分类号： A61N1/37 , A61N1/372 , G06F17/00 , A61B5/0452
CPC分类号： A61N1/3702 , A61B5/02405 , A61B5/7232 , A61N1/36592
摘要： An implantable cardiac rhythm management device (pacemaker or defibrillator) having circuitry for determining the interval between two successive natural ventricular depolarization signals, includes the capability of computing and storing histogram arrays of heart rate variability data over a prolonged period, such as 24 hours. By utilizing an algorithm for generating a histographic log and a time domain log wherein a logarithmic data compression technique is implemented, the volume of HRV data collected for later telemetered readout to an external device does not exceed the memory and power capabilities of the implanted device.
摘要翻译：具有用于确定两个连续的自然心室去极化信号之间的间隔的电路的可植入心律管理装置（起搏器或除颤器）包括在延长的时间段（例如24小时）上计算和存储心率变异性数据的直方图阵列的能力。通过利用用于生成组织学记录的算法和实现对数数据压缩技术的时域日志，收集用于稍后遥测读出到外部设备的HRV数据的量不超过植入设备的存储器和功率能力。

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